Successful surgical management of Leriche syndrome in a 30-year-old female patient: A rare case report.

Abstract

Introduction and importance: Leriche syndrome (LS), or aortoiliac occlusive disease, is a rare form of peripheral arterial disease leading to claudication, impotence, and diminished femoral pulses due to atheromatous obstruction of the infrarenal aorta and common iliac arteries. Early identification is crucial as untreated LS can result in severe complications. Treatment primarily involves surgical interventions, with endovascular options considered as alternatives.

Case presentation: A 30-year-old former smoker woman presented with calf pain after walking less than 50 m, coupled with a history of recurrent lower extremity arterial occlusions and previous abdominal aorta stenting. Examination revealed pallor and non-palpable pulses in both feet. Doppler imaging and CT scans indicated significant aortic stenosis and iliac artery occlusion. Following a successful bilateral aorto-femoral bypass, distal pulses improved, and the ankle-brachial index was 1 in both limbs. The patient was prescribed warfarin for ongoing management, emphasizing the importance of timely intervention in LS to restore limb perfusion.

Clinical discussion: LS is characterized by atheromatous obstruction of the infrarenal aorta and iliac arteries, causing claudication and absent femoral pulses. Diagnostic tools include the ankle-brachial index, Doppler ultrasound, and CT angiography. Management typically involves aortofemoral bypass or endovascular revascularization, coupled with lifestyle modifications.

Conclusion: Leriche syndrome poses significant morbidity if undiagnosed. This case highlights its impact on quality of life and limb ischemia risk, underscoring the need for accurate diagnostics and timely, personalized management for improved outcomes. Increased clinician awareness is vital for optimal care.